Scintigraphy

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Scintigraphy
Scintigraphy
ICD-9-CM92.0-92.1
MeSHD011877
OPS-301 code3-70

Scintigraphy (from Latin scintilla, "spark"), also known as a gamma scan, is a diagnostic test in

SPECT and positron emission tomography (PET) form 3-dimensional images and are therefore classified as separate techniques from scintigraphy, although they also use gamma cameras
to detect internal radiation. Scintigraphy is unlike a diagnostic X-ray where external radiation is passed through the body to form an image.

Process

Computer representation of false-color image of a cross section of human brain, based on scintillography in Positron-Emission Tomography

Scintillography is an

charged coupled device elements, and its resulting electrical waveform is processed by computers to provide two- and three-dimensional images of a subject or region of interest
.

Schematic of a photomultiplier tube coupled to a scintillator.
Cross section of a gamma camera.

Scintillography is mainly used in

neutrino detection underground tanks filled with tetrachloroethylene are surrounded by arrays of photo detectors in order to capture the extremely rare event of a collision between the fluid's atoms and a neutrino
.

Another extensive use of scintillography is in

electron-positron annihilation
phenomena.

By organ or organ system

Biliary system (cholescintigraphy)

Main article: Cholescintigraphy

Scintigraphy of the

gallbladder diseases, e.g. bile leaks of biliary fistulas.[2] In cholescintigraphy, the injected radioactive chemical is taken up by the liver and secreted into the bile. The radiopharmaceutical then goes into the bile ducts, the gallbladder, and the intestines. The gamma camera is placed on the abdomen to picture these perfused organs.[2] Other scintigraphic tests are done similarly.[2]

Lung scintigraphy

Lung scintigraphy evaluating lung cancer

The most common indication for lung scintigraphy is to diagnose pulmonary embolism, e.g. with a ventilation/perfusion scan and may be appropriate for excluding PE in pregnancy.[3] Less common indications include evaluation of lung transplantation, preoperative evaluation, evaluation of right-to-left shunts.[4]

In the ventilation phase of a ventilation/perfusion scan, a gaseous radionuclide

DTPA in an aerosol form (or ideally using Technegas, a radioaerosol invented in Australia by Dr Bill Burch and Dr Richard Fawdry) is inhaled by the patient through a mouthpiece or mask that covers the nose and mouth. The perfusion phase of the test involves the intravenous injection of radioactive technetium macro aggregated albumin
(Tc99m-MAA). A gamma camera acquires the images for both phases of the study.

Bone

Main article: Bone scintigraphy

For example, the ligand

methylene-diphosphonate (MDP) can be preferentially taken up by bone. By chemically attaching technetium-99m to MDP, radioactivity can be transported and attached to bone via the hydroxyapatite
for imaging. Any increased physiological function, such as a fracture in the bone, will usually mean increased concentration of the tracer.

Heart

A thallium stress test is a form of scintigraphy, where the amount of

Na+/K+ ion exchange pumps. Thallium binds the K+ pumps and is transported into the cells. Exercise or dipyridamole induces widening (vasodilation) of normal coronary arteries. This produces coronary steal from areas of ischemia where arteries are already maximally dilated. Areas of infarct or ischemic tissue will remain "cold". Pre- and post-stress thallium may indicate areas that will benefit from myocardial revascularization. Redistribution indicates the existence of coronary steal and the presence of ischemic coronary artery disease.[5]

Parathyroid

Main article:
Sestamibi parathyroid scintigraphy

Tc99m-

sestamibi is used to detect parathyroid adenomas.[6]

Thyroid

Main article: Radioactive iodine uptake test

To detect metastases/function of thyroid, the isotopes technetium-99m or iodine-123 are generally used,[7][8] and for this purpose the iodide isotope does not need to be attached to another protein or molecule, because thyroid tissue takes up free iodide actively.

Renal and urinary systems

Main article: Radioisotope renography

Full body

Examples are

tumors[9] such as pheochromocytomas and neuroblastomas
.

Function tests

Certain tests, such as the Schilling test and urea breath test, use radioisotopes but are not used to produce a specific image.

History

Scintigraphic scanning was invented and proven by Neurologist and Radiologist professor Bernard George Ziedses des Plantes.

Autoradiograph’. In 1970, the Physikalisch-Medizinische Gesellschaft für Neuroradiologie (The Physics and Medical Society for Neuroradiology) instituted the ‘Ziedses des Plantes Medal'. It was first awarded to W. Oldendorf en G. Hounsfield in 1974 for Computer Tomography (CT). Later, in 1985, the medal was awarded to Ziedses des Plantes himself. In 1977 he received The Roentgen Medal.[11]

See also

References

  1. ^ "Scintigraphy". Dorland's Medical Dictionary for Health Consumers; Saunders; Saunders Comprehensive Veterinary Dictionary (3rd ed.). McGraw-Hill Concise Dictionary of Modern Medicine. 2007.
  2. ^ a b c d "Definition of Scintigraphy". MedicineNet.com. 6 December 2003.
  3. PMID 28124411
    .
  4. ^ "Guideline for Lung Scintigraphy" (PDF) (3.0 ed.). Society of Nuclear Medicine Procedure. 7 February 2004. Archived from the original (PDF) on 23 July 2011. Retrieved 2 April 2010.
  5. ISBN 1-4051-0386-8
    .
  6. ISBN 978-0-9778882-1-4
    . Retrieved 17 July 2011.
  7. PMID 17914109
    .
  8. S2CID 44740573
    .
  9. PMID 17374863
    .
  10. doi:10.1148/radiology.191.3.876-b
    .
  11. ^ Busch, Dr. Uwe (1977). "The Roentgen Medal 1970-1979". Deutsches Röntgen Museum. Retrieved August 7, 2022.

External links

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